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International Journal of Legal Medicine Jul 2024Fluid-filled paranasal sinuses are suggested to be a valuable tool to distinguish between drowning and non-drowning postmortem, yet the mechanisms governing fluid entry...
Fluid-filled paranasal sinuses are suggested to be a valuable tool to distinguish between drowning and non-drowning postmortem, yet the mechanisms governing fluid entry remains unknown. We investigate if fluid-filled paranasal sinuses are caused by a passive influx from submersion or an active aspiration mechanism during drowning. The ovine nasal cavity and maxillary sinuses are remarkably similar anatomically to humans, and have been used for endoscopic surgical training in recent decades. We submerged 15 decapitated ovine heads from agricultural waste at a depth of 2 m in flowing water for 1, 8, and 24 h and 7 days. Paranasal sinuses were CT imaged and compared pre- and post-submersion to non-submerged controls. Furthermore, we examined the paranasal sinuses of a single homicide case of a non-drowned submerged subject. Results demonstrate that fluid passively enters the maxillary sinus postmortem in the non-drowned ovine heads following 1 h of submersion. Fluid volume was independent of submersion time and influenced by time out of water as well as handling, since volume was reduced between consecutive CT scans. In contrast to our hypothesis, the filling of the paranasal sinuses is due to passive influx of fluid from submersion rather than an active aspiration during drowning. The observation that paranasal sinuses were fluid-filled in a single medico-legal case of postmortem submersion supports the finding of passive influx. Consequently, careful interpretation of fluid-filled paranasal sinuses is required when bodies are found in water, as the finding cannot distinguish between postmortem submersion and drowning.
Topics: Animals; Drowning; Sheep; Paranasal Sinuses; Models, Animal; Tomography, X-Ray Computed; Immersion; Forensic Pathology; Humans; Postmortem Changes; Maxillary Sinus; Postmortem Imaging
PubMed: 38351206
DOI: 10.1007/s00414-024-03173-8 -
PloS One 2024As a key component of rotating machinery power transmission system, rolling bearings in gas turbines are often required to serve in complex working conditions such as...
As a key component of rotating machinery power transmission system, rolling bearings in gas turbines are often required to serve in complex working conditions such as the high speed, the heavy load, the variable load, the variable rotational speed, and so on. The signals of bearing failures are easily drowned out by strong background noise and disturbances of related components. In the mechanical transmission system, the signals of bearing failures are easily submerged by the strong background noise and the disturbance of related components, especially for the composite bearing failures, which seriously hinders the effective identification of the vibration characteristics of the bearing operating state and increases the difficulty of fault diagnosis. In order to investigate the impact of interference on the bearing, through the establishment of rolling bearing composite fault vibration model, analyze the relationship between the vibration signals caused by different types of bearing failures and the corresponding vibration characteristics, to reveal the transmission system of the parts of the perturbation of the main multi-interference factors on the bearing fault signal influence law. The experimental verification shows that disturbance yp(t) caused by the sum of gear meshing frequency, and installation errors of the shaft, and coupling in the transmission system and background noise ni(t), which makes the fault frequency relatively weak and difficult to observe, and makes it difficult to accurately separate the fault information of the bearing. It provides a theoretical basis to solve the problem of damage identification and fault diagnosis of rolling bearings under multi-interference state.
Topics: Humans; Vibration; Drowning; Physical Therapy Modalities
PubMed: 38346051
DOI: 10.1371/journal.pone.0297935 -
The American Journal of Emergency... May 2024A technique called in-water resuscitation (IWR) was devised on a surfboard to ventilate persons who seemingly did not breathe upon a water rescue. Despite IWR still... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
A technique called in-water resuscitation (IWR) was devised on a surfboard to ventilate persons who seemingly did not breathe upon a water rescue. Despite IWR still raises uncertainties regarding its applicability, this technique is recommended by the International Liaison Committee for Resuscitation (ILCOR). Thus, this study aimed to evaluate the feasibility of IWR with a rescue board before and during towing and, to compare rescue times and rescue-associated fatigue levels between rescues with rescue breath attempts and without (SR).
METHODS
A randomized crossover pilot test was conducted: 1) IWR test with pocket mask and, 2) Conventional SR test. IWR tests were conducted using a Laerdal ResusciAnne manikin (Stavanger, Norway). Three groups of variables were recorded: a) rescue time (in s), b) effective ventilations during rescue, and c) rating of perceived effort (RPE).
RESULTS
Focusing on the rescue time, the performance SR was significantly faster than IWR rescue which took 61 s longer to complete the rescue (Z = -2.805; p = 0.005). No significant differences were found between techniques for the RPE (T = -1.890; p = 0.095). In the IWR analysis, lifeguards performed an average of 27 ± 12 rescue breaths.
CONCLUSION
The application of IWR on a rescue board is feasible both at the time of rescue and during towing. It shortens the reoxygenation time but delays the arrival time to shore. Both IWR and SR result in similar levels of perceived fatigue.
Topics: Humans; Cardiopulmonary Resuscitation; Fatigue; Near Drowning; Pilot Projects; Water; Cross-Over Studies
PubMed: 38341994
DOI: 10.1016/j.ajem.2024.02.010 -
Journal of Evolutionary Biology Mar 2024Flooding or rain is a threat to many insects in nature, including herbivorous invertebrates whose hosts are emergent aquatic plants. They may thus have developed...
Flooding or rain is a threat to many insects in nature, including herbivorous invertebrates whose hosts are emergent aquatic plants. They may thus have developed particular adaptations to withstand the flooding that is a feature of emergent plants' environment. The aphid Hyalopterus pruni (Hemiptera: Aphididae) modifies the physical and chemical conditions of its habitat by periodically spreading wax around itself with its hind legs. This behaviour constitutes a form of niche construction. We hypothesized that the aphid decreases its risk of death of own or around other individuals when submerged in water by spreading wax powder secreted from its body onto the leaves of its host plant, Phragmites australis. We compared the hydrophobicity of waxed and normal leaf surfaces. Next, we compared the survival rates of wax-powdering and nonwax-powdering aphids under submerged and rainy conditions in the laboratory and in the field. Finally, we examined whether the aphids' wax-powdering behaviour increased as a result of experiencing brief submergence or rain. The surface of the waxed area was significantly more water-repellent than the surface of unwaxed leaves. The waxed areas held air bubbles when under water. In experiments, aphids without wax around themselves exhibited lower survival rates: 22.9% in laboratory conditions and 15.7% in field conditions after 48 hr underwater. In contrast, aphids that secreted wax had higher survival rates, with 41.5% and 38.2% under laboratory and field conditions, respectively, after the same duration. Aphids exposed to rainfall showed similar results. Moreover, aphids that had experienced rain or submersion for 24 hr engaged in increased wax-powdering behaviour. These results indicate that aphids reduce their risk of drowning by powdering secreted wax onto the surface of leaves around them. Our findings suggest that niche construction by herbivorous invertebrates supports their ability to utilize host plants that grow under stressful conditions, such as emergent plants that are subject to periodic inundation.
Topics: Humans; Animals; Aphids; Herbivory; Laboratories; Plant Leaves; Water
PubMed: 38340333
DOI: 10.1093/jeb/voae011 -
Journal of Imaging Informatics in... Jun 2024Drowning diagnosis is a complicated process in the autopsy, even with the assistance of autopsy imaging and the on-site information from where the body was found....
Drowning diagnosis is a complicated process in the autopsy, even with the assistance of autopsy imaging and the on-site information from where the body was found. Previous studies have developed well-performed deep learning (DL) models for drowning diagnosis. However, the validity of the DL models was not assessed, raising doubts about whether the learned features accurately represented the medical findings observed by human experts. In this paper, we assessed the medical validity of DL models that had achieved high classification performance for drowning diagnosis. This retrospective study included autopsy cases aged 8-91 years who underwent postmortem computed tomography between 2012 and 2021 (153 drowning and 160 non-drowning cases). We first trained three deep learning models from a previous work and generated saliency maps that highlight important features in the input. To assess the validity of models, pixel-level annotations were created by four radiological technologists and further quantitatively compared with the saliency maps. All the three models demonstrated high classification performance with areas under the receiver operating characteristic curves of 0.94, 0.97, and 0.98, respectively. On the other hand, the assessment results revealed unexpected inconsistency between annotations and models' saliency maps. In fact, each model had, respectively, around 30%, 40%, and 80% of irrelevant areas in the saliency maps, suggesting the predictions of the DL models might be unreliable. The result alerts us in the careful assessment of DL tools, even those with high classification performance.
Topics: Humans; Deep Learning; Drowning; Aged; Child; Aged, 80 and over; Tomography, X-Ray Computed; Adolescent; Adult; Autopsy; Middle Aged; Female; Retrospective Studies; Male; Young Adult; ROC Curve; Reproducibility of Results; Postmortem Imaging
PubMed: 38336949
DOI: 10.1007/s10278-024-00974-6 -
The Science of the Total Environment Mar 2024Microplastics (MPs) composed of different polymers with various shapes, within a vast granulometric distribution (1 μm - 5 mm) and with a wide variety of... (Review)
Review
Microplastics (MPs) composed of different polymers with various shapes, within a vast granulometric distribution (1 μm - 5 mm) and with a wide variety of physicochemical surface and bulk characteristics spiral around the globe, with different atmospheric, oceanic, cryospheric, and terrestrial residence times, while interacting with other pollutants and biota. The challenges of microplastic pollution are related to the complex relationships between the microplastic generation mechanisms (physical, chemical, and biological), their physicochemical properties, their interactions with other pollutants and microorganisms, the changes in their properties with aging, and their small sizes that facilitate their diffusion and transportation between the air, water, land, and biota, thereby promoting their ubiquity. Early career researchers (ERCs) constitute an essential part of the scientific community committed to overcoming the challenges of microplastic pollution with their new ideas and innovative scientific perspectives for the development of remediation technologies. However, because of the enormous amount of scientific information available, it may be difficult for ERCs to determine the complexity of this environmental issue. This mini-review aims to provide a quick and updated overview of the essential insights of microplastic pollution to ERCs to help them acquire the background needed to develop highly innovative physical, chemical, and biological remediation technologies, as well as valorization proposals and environmental education and awareness campaigns. Moreover, the recommendations for the development of holistic microplastic pollution remediation strategies presented here can help ERCs propose technologies considering the environmental, social, and practical dimensions of microplastic pollution while fulfilling the current government policies to manage this plastic waste.
Topics: Microplastics; Plastics; Environmental Monitoring; Water Pollutants, Chemical; Environmental Pollutants; Ecosystem
PubMed: 38307272
DOI: 10.1016/j.scitotenv.2024.170382 -
Scientific Reports Jan 2024Secure archaeological evidence for human occupation on the eastern seaboard of Australia before ~ 25,000 years ago has proven elusive. This has prompted some...
Secure archaeological evidence for human occupation on the eastern seaboard of Australia before ~ 25,000 years ago has proven elusive. This has prompted some researchers to argue that the coastal margins remained uninhabited prior to 25 ka. Here we show evidence for human occupation beginning between 30 ± 6 and 49 ± 8 ka at Wallen Wallen Creek (WWC), and at Middle Canalpin Creek (MCA20) between 38 ± 8 and 41 ± 8 ka. Both sites are located on the western side of Minjerribah (North Stradbroke Island), the second largest sand island in the world, isolated by rising sea levels in the early Holocene. The earliest occupation phase at both sites consists of charcoal and heavily retouched stone artefacts made from exotic raw materials. Heat-treatment of imported silcrete artefacts first appeared in sediment dated to ~ 30,000 years ago, making these amongst Australia's oldest dated heat-treated artefacts. An early human presence on Minjerribah is further suggested by palaeoenvironmental records of anthropogenic burning beginning by 45,000 years ago. These new chronologies from sites on a remnant portion of the continental margin confirm early human occupation along Sahul's now-drowned eastern continental shelf.
Topics: Humans; Occupations; Australia; Sea Level Rise; Archaeology; Sand; Fossils
PubMed: 38296988
DOI: 10.1038/s41598-024-52000-y -
BMJ Open Jan 2024The Package of Essential Noncommunicable Disease Interventions-Plus (PEN-Plus) is a strategy decentralising care for severe non-communicable diseases (NCDs) including...
Protocol for an evaluation of the initiation of an integrated longitudinal outpatient care model for severe chronic non-communicable diseases (PEN-Plus) at secondary care facilities (district hospitals) in 10 lower-income countries.
INTRODUCTION
The Package of Essential Noncommunicable Disease Interventions-Plus (PEN-Plus) is a strategy decentralising care for severe non-communicable diseases (NCDs) including type 1 diabetes, rheumatic heart disease and sickle cell disease, to increase access to care. In the PEN-Plus model, mid-level clinicians in intermediary facilities in low and lower middle income countries are trained to provide integrated care for conditions where services traditionally were only available at tertiary referral facilities. For the upcoming phase of activities, 18 first-level hospitals in 9 countries and 1 state in India were selected for PEN-Plus expansion and will treat a variety of severe NCDs. Over 3 years, the countries and state are expected to: (1) establish PEN-Plus clinics in one or two district hospitals, (2) support these clinics to mature into training sites in preparation for national or state-level scale-up, and (3) work with the national or state-level stakeholders to describe, measure and advocate for PEN-Plus to support development of a national operational plan for scale-up.
METHODS AND ANALYSIS
Guided by Proctor outcomes for implementation research, we are conducting a mixed-method evaluation consisting of 10 components to understand outcomes in clinical implementation, training and policy development. Data will be collected through a mix of quantitative surveys, routine reporting, routine clinical data and qualitative interviews.
ETHICS AND DISSEMINATION
This protocol has been considered exempt or covered by central and local institutional review boards. Findings will be disseminated throughout the project's course, including through quarterly M&E discussions, semiannual formative assessments, dashboard mapping of progress, quarterly newsletters, regular feedback loops with national stakeholders and publication in peer-reviewed journals.
Topics: Humans; Noncommunicable Diseases; Hospitals, District; Secondary Care Centers; Ambulatory Care; India
PubMed: 38296295
DOI: 10.1136/bmjopen-2023-074182 -
Heliyon Jan 2024Identifying risk factors would help consider suicide prevention in any specific population. We aimed to assess suicidal behaviour among university students in the UK.
INTRODUCTION
Identifying risk factors would help consider suicide prevention in any specific population. We aimed to assess suicidal behaviour among university students in the UK.
METHODS
An extensive keyword search was conducted through PubMed, Cochrane, CINHAL Plus, PubMed Central, Web of Science, Trip database, and Science Direct, following the PRISMA guidelines to identify different publications. The search strategy for the literature review was based on the Population Exposure Outcome framework. Critical appraisal utilised the CASP tool for cohort studies and the AXIS tool for cross-sectional studies, resulting in 14 included studies. A narrative synthesis was performed.
RESULTS
Postgraduate and undergraduate students used different suicidal methods such as poisoning, jumping, hanging, drowning, and suffocating, with jumping most preferred by male students. The predisposing factors of suicide among university students included: mental health problems (depression, psychological stress, psychosis, mania, neuroticism, financial anxiety, imperfect parents' connection with students), sexual orientation with risk of suicide among non-heterosexual students due to lowered self-esteem from feeling disregarded, disrespected and insufficient attention from the surrounding. Suicidal behaviour was high among unmarried students, male and unemployed female students, and students with childhood experiences such as physical abuse, family violence, emotional abuse, neglect, and physical punishment-gender, with females seeking more services from general hospitals with more suicide attempts in older females. High risk was also noted in males, with increased risk in white students compared to black students.
CONCLUSION
The review highlighted that students with previous mental health problems, a history of experiencing sexual abuse in childhood, bad relationships with their mother, disrespect and disregard in the community due to sexual identity are the major contributing factors for suicide among university students in the UK.
PubMed: 38293523
DOI: 10.1016/j.heliyon.2024.e24069 -
Cureus Dec 2023Background Cardiopulmonary resuscitation (CPR) is a life-saving procedure that can be performed in many situations where a person's breathing or heartbeat has stopped,...
Assessment of Knowledge, Attitudes, and Willingness Among People With and Without Heart Disease Relatives in Saudi Arabia Regarding Cardiopulmonary Resuscitation: A Cross-Sectional Study.
Background Cardiopulmonary resuscitation (CPR) is a life-saving procedure that can be performed in many situations where a person's breathing or heartbeat has stopped, such as during a heart attack, suffocation, near drowning, or electrical injuries. Despite its importance, to our knowledge, no research has been conducted yet in our community on the differences in CPR knowledge, attitudes, and willingness between those with and without heart disease relatives. Objective This study aimed to assess the level of knowledge, attitude, and willingness of people with and without heart disease relatives to perform CPR in a case of cardiac arrest. Methods A descriptive cross-sectional study was carried out between July 2023 and October 2023 among the Saudi Arabia population using a self-administered online questionnaire focusing on the sociodemographic characteristics of participants and the level of knowledge, attitude toward CPR, and the willingness to perform CPR in a case of cardiac arrest. Results This study included 799 participants, with 331 males (41.4%) and 468 females (58.6%). Age distribution was mainly in the range of 18-25 years (241 participants, 30.2%). Geographically, the highest proportion was from the southern region (214 participants, 26.8%). The majority had a university degree (533 participants, 66.7%). Employment status varied, with 401 participants (50.2%) working outside the medical field. Monthly income showed that 297 (37.2%) had an income ranging from 2,000 to 10,000 SAR. The average daily sleep duration varied, with the majority (64.7%) reporting six to nine hours of sleep. Also, 44.2% of participants reported exercising. Regarding smoking status, 80.9% reported not smoking. A family history of heart disease was reported by 46.4% of participants, whereas 16.3% reported a personal diagnosis of heart disease. Regarding knowledge, 40.8% correctly identified when CPR should be performed. Only 40.4% correctly identified the first step in a CPR situation, and only 22.9% identified the correct sequence of steps for performing CPR. Additionally, only 66.5% correctly identified the emergency hotline number "Red Crescent." Furthermore, only 8.9% knew the correct compression/ventilation ratio for adults during CPR. As for the attitude, a significant percentage (65.0%) had not taken a CPR course. However, the majority (84.6%) expressed a strong desire to learn CPR. Interestingly, the participants showed a positive attitude toward CPR education. Among the participants, 53.9% responded that they performed CPR when encountering a situation that required it, while 46.1% did not. Regarding the participants' willingness to perform CPR on different individuals, the majority (74.1%) expressed their readiness to perform CPR whenever needed. Conclusion The findings demonstrated knowledge gaps, with misconceptions about CPR. However, participants generally expressed a positive attitude toward CPR education and a willingness to learn. Factors such as age showed a weak association with knowledge level, while gender, region, education, employment, and family history of heart disease did not significantly impact knowledge. The study highlighted the need for improved CPR education and awareness. Hence, we recommend CPR courses to be implemented as a graduation prerequisite. In addition to that, linking some government services to a first aid course would positively impact the general population's practices in CPR and other emergencies.
PubMed: 38283415
DOI: 10.7759/cureus.51197